City of Hope has one of the most renowned brain tumor programs in the United States, with a multidisciplinary team of medical experts across different fields including surgery, radiation oncology, medical oncology and supportive care medicine. Together, they work collaboratively to plan and implement a treatment regimen that is individually tailored to the patient to improve survival chances, enhance outcomes, minimize side effects and boost quality of life.

Surgery

For operable brain tumors, surgical removal of the cancer is typically the first treatment provided and can be curative for early stage patients. However, it is also a viable option for patients with advanced or high-grade tumors, significantly improving outcomes and quality of life. Our
neurosurgery team’s
focus on researching and treating brain tumors also means they can target tumors that are considered inoperable elsewhere.

City of Hope’s neurosurgeons also specialize in
minimally invasive procedures
whenever possible. By using fewer incisions and making smaller cuts, our surgeons can remove and extract the tumor with minimal impact to the surrounding healthy brain tissue. As a result, patients experience less discomfort, fewer post-surgical complications and a faster recovery time.

These procedures include:

Intraoperative cortical mapping: This technology gives the surgeon a computerized map of key brain regions, including speech, motor and sensory centers. By avoiding these critical areas, the risk of neurological damage is minimized while allowing as much of the tumor to be removed as possible.

Image-guided surgical navigation: This technology helps guide the removal of tumors that are difficult to visualize or are located in “high-risk” areas of the brain by using preoperative magnetic resonance images (MRIs).

Endoscopic surgery: Certain brain surgery procedures may be performed through an endoscope - a thin, lighted tube that requires a small opening and accommodates tiny surgical tools. Smaller openings minimize postoperative discomfort and risk of infection. City of Hope researchers are working to develop a miniaturized surgical system that will allow brain surgeries to be even less invasive, with an even lower risk of complications.

Our neurosurgeons also work closely with radiation and medical oncologists so that multiple treatments can be performed in one procedure. For example, after resection they can apply chemotherapy directly to the surgery site, which can kill remaining tumor cells and reduce the likelihood of recurrence.

Radiation Therapy

For some brain tumors — particularly those that cannot be treated with surgery —
radiation
can target and kill brain tumor cells, improving survival outcomes and providing symptom relief.

Radiation may also be performed after surgery to kill any remaining abnormal cells at the tumor site, or combined with chemotherapy to improve the effectiveness of both therapies.

In addition to standard radiation regimens, City of Hope also offers
Helical TomoTherapy,
an advance technology combining radiation delivery with advanced imaging. This allows the radiation beams to be “sculpted” to the tumor’s size and shape, resulting in more focused radiation on the cancer site while minimizing exposure to adjacent tissues and organs. This can reduce the likelihood and severity of side effects, as well as preserving cognitive function.

Alternating Electric Field Therapy

Brain tumor patients at City of Hope may be treated by the recently approved alternating electric field therapy (also known as tumor treating fields or TTF.) This treatment targets and attacks tumor cells through an alternating, low-intensity electrical field, blocking tumor cell division processes.

The therapy is non-invasive (the current-producing transducers are placed directly on the skin around the tumor region) and is portable, allowing patients to be continuously treated while they go about their normal activities throughout the day.

Drug Therapy

City of Hope uses a wide range of chemotherapy, targeted therapy and immunotherapy drugs to treat brain tumors. These drugs may be taken orally, intravenously (injected into the bloodstream) or applied directly at the tumor site during surgery.

These drugs can also enhance the effectiveness of other brain tumor treatments by shrinking the tumor beforehand — making it easier to extract with surgery or target with radiation — or lowering chances of recurrence afterwards by targeting and attacking any remaining tumor cells.

As part of the treatment team, a
medical oncologist
will evaluate the patient’s cancer, health and other factors, so that the drug therapy regimen can be tailored to the patient throughout the continuum of care.

City of Hope has some of the most advanced tools for the surgical removal of brain and spine tumors. Learn how these tools have enabled surgery of the highest precision while minimizing adverse outcomes.

City of Hope’s
Division of Neurosurgery
focuses on surgical treatment of both benign and malignant brain, spine and pituitary tumors. Our physicians are nationally-recognized experts in neurosurgery and neuro-oncology, and employ today’s leading edge therapies.

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